April 30, 2008 – "Diabetes is a growing epidemic in the Philippines that shows no sign of slowing down. There are various complications attributable to diabetes and diabetes morbidity and mortality are expected to rise if we will not be able to manage and treat the disease," said Dr. Araceli Panelo, executive director of the UERM Institute for Studies on Diabetes Foundation (ISDF) during a press meeting hosted by pharmaceutical company Merck Sharp & Dohme (MSD). 

"Complications linked to type 2 diabetes include coronary heart disease, kidney failure, diabetic foot disease, nerve damage, stroke, hypertension, depression, reduced quality of life, etc. As doctors, we are happy that new advances in the management of type 2 diabetes are continuously being developed to bring hope to patients and their families."

According to Dr. Panelo, agents that improve glucose control without producing hypoglycemia and weight gain will address the need that has been unmet by the traditional antidiabetes agents."

There are many available therapies in the market today but have some safety and tolerability limitations which hinder the ability to achieve glucose control of patients. Recently, an approved therapy promising a fresh approach, offering better side-effect profile and route of administration.

“DPP-4 inhibitors are an important breakthrough. They represent an innovative and different approach to treating diabetes, a disease that is rapidly increasing in prevalence and exacting huge costs on a personal and global level. A lot of patients being treated are not achieving target blood sugar levels, suggesting that current therapies have significant limitations," said Dr. Sjoberg Kho, a known endocrinologist and consultant at the UST Hospital.  He added that, "the recent approval of sitagliptin, a DPP-4 inhibitor, in combination with metformin, is an exciting new option that can effectively lower blood sugar levels with fewer unwanted side effects (such as hypoglycaemia and weight gain) often associated with existing diabetes medicines. In fact, in a large controlled clinical trial, patients taking sitagliptin plus metformin lost weight compared to patients taking glipizide plus metformin who gained weight. Also, this new combination medicine was well tolerated in large controlled clinical trials. The combination of a DDP-4 inhibitor and metformin can benefit many diabetic patients."

In clinical trials with patients treated with sitagliptin and metformin, all doses of sitagliptin plus metformin were generally well-tolerated. Gastrointestinal side effects, including nausea, vomiting, abdominal pain and diarrhea, were similar to metformin alone.

            Consistent with metformin prescribing information, sitagliptin/metformin HCI is contraindicated in patients with renal disease or renal dysfunction, congestive heart failure requiring a pharmacological agent, acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma.  It is not indicated for use in patients with type 1 diabetes.  It is contraindicated in patients with known hypersensitivity to sitagliptin, metformin hydrocholoride, or any other component of the medicine.  The safety and efficacy of the medicine in pregnant or nursing women and in pediatric patients has not been established.  Therefore, it should not be used in these patients.  Lactic acidosis, a rare, but serious, metabolic complication, may occur during treatment with the medicine.

  Sitagliptin/metformin HCI is indicated as initial therapy to improve glycaemic control in patients with type 2 diabetes who are not adequately controlled with diet and exercise alone. It is also indicated as an adjunct to diet and exercise to improve glycaemic control in patients with type 2 diabetes who are not adequately controlled on metformin or sitagliptin alone or in patients already being treated with a combination of sitagliptin plus metformin.

About Sitagliptin/Metformin HCI

Sitagliptin/Metformin HCI harnesses the comprehensive modes of action of two effective treatments – the incretin-enhancing power of a dipeptidyl peptidase-4 (DPP-4) inhibitor and the proven glucose-lowering benefits of metformin. DPP-4 inhibitors work by enhancing the body's own ability to lower blood sugar (glucose).  Sitagliptin/Metformin HCI as a combination medicine provides substantially additive glucose-lowering efficacy with a similar safety and tolerability profile to metformin alone. This unique new therapy enables physicians to deliver comprehensive coverage against core defects of type 2 diabetes.

About Merck Sharp & Dohme (MSD)

Merck Sharp & Dohme (MSD) is a global research-driven pharmaceutical company dedicated to putting patients first. Established in 1891, MSD currently discovers, develops, manufactures and markets vaccines and medicines to address unmet medical needs.  The Company devotes extensive efforts to increase access to medicines through far-reaching programs that not only donate MSD medicines but help deliver them to the people who need them.  MSD also publishes unbiased health information as a not-for-profit service. 

Recognizing the toll that the diabetes epidemic is taking globally, MSD has committed its research efforts toward diabetes as one of the nine major therapeutic areas of focus to help bring hope to patients and stop this growing pandemic.